Natta F, Passarelli E, Rosso M V
Regione Piemonte, USSL n. 36, Presidio Ospedaliero di Susa, Torino.
Minerva Chir. 1994 Jun;49(6):529-32.
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, occurring in 1-3% of autoptic studies. It's remnant of the omphalomesenteric duct which connects the primitive gut to the yolk sac in early fetal life and the failure of obliteration may result in an omphalomesenteric fistula, an enterocyst, a fibrous band connecting the small intestine to he umbilicus. It's a true diverticulum arising from the antimesenteric border of the small bowel and often is associated with inflammatory bowel disease. Usually Meckel's diverticulum is asymptomatic; when it's complicated by bleeding, obstruction and inflammation, occurs as a symptomatic lesion but it's difficult to diagnose, because its signs and symptoms are identical to such common as Crhon's disease, appendicitis, and peptic ulcer diseases. The preoperative diagnosis of a Meckel's diverticulum, especially in the adult when asymptomatic, is still a serious problem; X-ray, US, radioisotopic scan and TAC are noninvasive, nonspecific test for the detection of this lesion. Many authors had suggested (to prevent its complications), the routine search during every laparotomy, with its surgical resection also in asymptomatic cases. The authors report their fifteen years experience in the diagnosis and treatment of 29 cases of patients with Meckel's diverticulum in the Susa Hospital (1976-1991).
梅克尔憩室是胃肠道最常见的先天性异常，在1% - 3%的尸检研究中出现。它是卵黄管的残余物，在胎儿早期将原始肠道与卵黄囊相连，闭塞失败可能导致卵黄管瘘、肠囊肿、连接小肠与脐的纤维带。它是从小肠系膜对侧缘产生的真性憩室，常与炎症性肠病相关。通常梅克尔憩室无症状；当它并发出血、梗阻和炎症时，作为有症状的病变出现，但难以诊断，因为其体征和症状与克罗恩病、阑尾炎和消化性溃疡病等常见疾病相同。梅克尔憩室的术前诊断，尤其是在无症状的成年人中，仍然是一个严重问题；X线、超声、放射性核素扫描和CT是检测这种病变的非侵入性、非特异性检查。许多作者建议（为预防其并发症），在每次剖腹手术时常规探查，在无症状病例中也进行手术切除。作者报告了他们在苏萨医院（1976 - 1991年）对29例梅克尔憩室患者的诊断和治疗的15年经验。
